Cromlin H, Rodriguez-Villalobos H, Deplano A, Duprez T, Hantson P
Department of Intensive Care, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Laboratory of Microbiology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Case Rep Infect Dis. 2017;2017:8976754. doi: 10.1155/2017/8976754. Epub 2017 Nov 26.
Spontaneous or nosocomial meningitis remains rare in healthy adults but is still carrying a high mortality rate despite adapted antimicrobial treatment for susceptible strains. A 39-year-old woman was admitted to the hospital with severe subarachnoid haemorrhage complicated by acute hydrocephalus. On hospital day 10, she developed septicaemia and urinary tract infection due to a multisensitive strain of . This infection was successfully controlled by antimicrobial therapy. As a late complication in the neurosurgical ward (day 39), she developed fever, alteration of consciousness, and shock, leading to the diagnosis of bacterial meningitis. The culture of blood, cerebrospinal fluid, and urine grew positive for a multisensitive . The strain was identified as O117:K52:H, a serotype that was until now never associated with acute meningitis or brain abscesses. The source appeared to be the urinary tract with the demonstration of acute pyelonephritis. The patient died on day 94 from delayed complications of multiple brain abscesses.
自发性或医院获得性脑膜炎在健康成年人中仍然罕见，但尽管针对敏感菌株采用了适当的抗菌治疗，其死亡率仍然很高。一名39岁女性因严重蛛网膜下腔出血并发急性脑积水入院。在住院第10天，她因多重敏感菌株感染发生败血症和尿路感染。这种感染通过抗菌治疗得到成功控制。作为神经外科病房的晚期并发症（第39天），她出现发热、意识改变和休克，导致细菌性脑膜炎的诊断。血液、脑脊液和尿液培养对多重敏感菌株呈阳性。该菌株被鉴定为O117:K52:H，这是一种迄今为止从未与急性脑膜炎或脑脓肿相关的血清型。感染源似乎是泌尿系统，伴有急性肾盂肾炎。患者于第94天死于多发性脑脓肿的延迟并发症。
